SURGERY NEETPG PRACTICE
Questions and Correct Answers
1)22y/o man with blunt thoracic trauma remains tachypneic & hypotensive despite
aggressive fluid resuscitation. Most likely diagnosis?
Ans Flail chest with multiple rib fractures & lung contusion
2)23y/o man with GSW to RUQ is in hemorrhagic shock with distended abdomen. What is the
next step in management?
Ans Emergent exploratory laparotomy, without waiting for FAST or CT scan
3)27y/o basketball player jumps to block a shot with his right hand. As his hand contacts the
ball, he feels severe pain in his right shoulder. He holds his right arm slightly abducted and
externally rotated. What is the diagnosis? What are the two main complications?
Ans
Diagnosis: anterior dislocation of the humeral head
Ans
,Main complications: axillary nerve damage with paralysis of the deltoid & teres minor muscle
as well as loss of sensation over lateral upper arm; axillary artery damage
Ans
4)29y/o woman with full-thickness burn below her right elbow has circumferential eschar
over right arm on day 3 & complains of pain & paresthesia in her right hand. What are the
next steps in management?
Ans
1. Doppler ultrasound to document peripheral pulses & estimate tissue compartment
pressure
Ans
2. Escharotomy (cut only through eschar layer) if pressure is 25-40mmHg
Ans
3. Fasciotomy if escharotomy does not improve perfusion
Ans
,5)31y/o male was hit by a car after attending a party where he drank a lot of fuice. He
complains of diffuse abdominal pain that refers to his left shoulder. Which part of the bladder
is most likely injured?
Ans
Bladder dome: only region covered by peritoneum, allowing leakage of urine into the
peritoneum and producing Kehr's sign; the dome is also most susceptible to rupture because
the bladder wall is weaker there
Ans
6)31y/o man has acute pain & swelling of the midline sacrococcygeal skin & subQ tissues.
what is it?
Ans
Infection of a pilonidal cyst
Ans
7)31y/o trauma victim is in hemorrhagic shock with decreased breath sounds on the left,
dullness to percussion on the left and slight tracheal deviation to the right. What is the
diagnosis?
, Ans
Hemothorax
Ans
8)34y/o man from Mexico with ongoing massive hemoptysis has dense opacity in right upper
lobe on CXR. What do you do (5)?
Ans
1. Intubate patient to protect his airway & prevent asphyxiation
Ans
2. Place bleeding lung in dependent position (lateral decubitus on side of affected lung)
Ans
3. IV fluids
Ans
4. Bedside bronchoscopy to visualize the lesion & control the bleeding
Questions and Correct Answers
1)22y/o man with blunt thoracic trauma remains tachypneic & hypotensive despite
aggressive fluid resuscitation. Most likely diagnosis?
Ans Flail chest with multiple rib fractures & lung contusion
2)23y/o man with GSW to RUQ is in hemorrhagic shock with distended abdomen. What is the
next step in management?
Ans Emergent exploratory laparotomy, without waiting for FAST or CT scan
3)27y/o basketball player jumps to block a shot with his right hand. As his hand contacts the
ball, he feels severe pain in his right shoulder. He holds his right arm slightly abducted and
externally rotated. What is the diagnosis? What are the two main complications?
Ans
Diagnosis: anterior dislocation of the humeral head
Ans
,Main complications: axillary nerve damage with paralysis of the deltoid & teres minor muscle
as well as loss of sensation over lateral upper arm; axillary artery damage
Ans
4)29y/o woman with full-thickness burn below her right elbow has circumferential eschar
over right arm on day 3 & complains of pain & paresthesia in her right hand. What are the
next steps in management?
Ans
1. Doppler ultrasound to document peripheral pulses & estimate tissue compartment
pressure
Ans
2. Escharotomy (cut only through eschar layer) if pressure is 25-40mmHg
Ans
3. Fasciotomy if escharotomy does not improve perfusion
Ans
,5)31y/o male was hit by a car after attending a party where he drank a lot of fuice. He
complains of diffuse abdominal pain that refers to his left shoulder. Which part of the bladder
is most likely injured?
Ans
Bladder dome: only region covered by peritoneum, allowing leakage of urine into the
peritoneum and producing Kehr's sign; the dome is also most susceptible to rupture because
the bladder wall is weaker there
Ans
6)31y/o man has acute pain & swelling of the midline sacrococcygeal skin & subQ tissues.
what is it?
Ans
Infection of a pilonidal cyst
Ans
7)31y/o trauma victim is in hemorrhagic shock with decreased breath sounds on the left,
dullness to percussion on the left and slight tracheal deviation to the right. What is the
diagnosis?
, Ans
Hemothorax
Ans
8)34y/o man from Mexico with ongoing massive hemoptysis has dense opacity in right upper
lobe on CXR. What do you do (5)?
Ans
1. Intubate patient to protect his airway & prevent asphyxiation
Ans
2. Place bleeding lung in dependent position (lateral decubitus on side of affected lung)
Ans
3. IV fluids
Ans
4. Bedside bronchoscopy to visualize the lesion & control the bleeding
